What I talk about in my daily neurology team rounds

Pharmacokinetiks

An 82yo patient develops proximal weakness over night. Pressing here biceps and quadriceps hurts more than it should. Her medication includes Ramipril, Bisoprolol, Amiodarone, Simvastatin, Amlodipine, Clopidogrel, Omeprazole (used to have phenprocoumon up to a few weeks ago, a european vitamin k antagonist).

Simvastatin is metabolized via the Cyt450 3A4 pathway, one of the most common in Neurology. It is a cheap and good drug, but it has many interactions, which we can see on fachinfo.de. We discuss ways to avoid these pharmakokinetics hardships.

Since we don’t have an electronic medication chart, we have to use IPhone interaction checkers or drugs.com (which I recommend) – learn to use this fine tool.